Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

I’m
30 weeks pregnant. I have really enjoyed receiving the weekly
Lamaze email. It has helped me stay confident and relaxed
during a stressful time. I always thought that when I had
kids it would be in the most natural way possible. My mother
had 4 children in a birthing center in Seattle and always said it
was the most amazing experience.

My problem is
this: At about 20 weeks the doctors said they found only one
artery in the umbilical cord. Since then it had been non-stop
monitoring. I have been getting an ultrasound every three
weeks all in the name of “better safe than
sorry”. Every time I go in they tell me about the
eventual problems that may occur, but scans have always shown the
baby having a normal growth rate and further ultrasounds ruled out
any birth defects. At my last visit they said that the umbilical
flow is “borderline normal” and now they want to
monitor me with ultrasounds once a week.

My questions are
these: How do I stay confident? All this testing and
constant hospital visits make me feel incapable, what can I
do? Sometimes I would like to quit all this testing and just
carry out the pregnancy normally, would that be a irresponsible
decision? Do you know what could happen to me or my baby if I
refused further monitoring?

Have you ever heard of
such a situation or know to whom I could refer that has had
experience with something similar? If you could offer me any kind
of advice, it would be greatly appreciated. If not could you
refer me to anyone (or anything online) that could help answer my
questions?

I searched on "single umbilical artery" on Medline Plus, the
U.S. National Library of Medicine's consumer health site and came
up with
this. It doesn't say anything more than what you already know,
that is, that babies are more likely to have other abnormalities,
which has been ruled out in your case.

From what I can judge from your post, it isn't so much that your
baby has a problem that is causing you distress but that you
are feeling in the dark about what the problem means and what might
need to be done about it. Here are some questions you may wish to
ask:

Now that we have ruled out other abnormalities, what are the
potential problems, if any, with having a single uterine
artery? If there are problems, how likely are they to occur?

What are you looking for when you perform (insert name of
test)? How accurate is this test at predicting a problem?

What treatment will you recommend if (insert name of problem)
occurs? If that doesn't resolve the problem, what would be the next
step?

Can you please direct me to where I can get more information on
this issue?

Barring an emergency, you will want to make informed decisions
about your care. This is not only what will best take care of
you and your baby, it is also your legal right. This acronymn will
help.

Benefits: Why is this drug/procedure/restriction being
recommended?

Risks: What are its risks? How likely are they to occur?
What other medical interventions might be needed as a result of
this one?

Alternatives: What are my other options, including doing
nothing? What are the benefits and risks of each of
those?

Intuition/instinct: Once you have the information, allow
yourself time to process it, and then listen to what your heart is
telling you.

No or not now: You ask if it would be irresponsible to
refuse further tests or treatments. Once you know the benefits
and risks of the proposed test or treatment, you will know the
answer to this question. If you decide to say "no" or "not now,"
discuss the circumstances that would change that answer.

During the
discussion, ask yourself whether you are getting information or
feelings. Hopefully, you are getting facts neutrally
presented, but unfortunately, it is not uncommon for care
providers to attempt to scare or bully women into doing what
the care provider wants to do. If you find this to be the case, I
would seriously think about changing care providers. Whatever
the situation, you want care providers who respect and trust you
and consider you a full partner in the decisions made about your
and your baby's care. If it comes to looking for a different
doctor, get back to me. I can give you some ideas for how to go
about that and what to look for.

~
Henci

All Times America/New_York

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Please note that this Forum is intended to help women make informed decisions about their care. The content is not a substitute for medical advice.